Individual
ELEANOR LYNN DEGUZMAN-BERUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
108 KNELLS RIDGE BLVD, SUITE 100, CHESAPEAKE, VA 23320-4885
(757) 436-1234
(757) 548-3665
Mailing address
108 KNELLS RIDGE BLVD, SUITE 100, CHESAPEAKE, VA 23320-4885
(757) 436-1234
(757) 548-3665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101058721
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080140047
RAILROAD MEDICARE
—
01
—
264508
ANTHEM BCBS
VA
01
—
5524667
AETNA
—
05
—
5636167
—
VA
01
—
CIGNA
2890231
—
Enumeration date
03/10/2006
Last updated
07/27/2021
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